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SANDOSTATIN LAR DEPOT
Cytoprotective and supportive care agents
Pituitary disorders
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Drug Name:

SANDOSTATIN LAR DEPOT Rx

Generic Name and Formulations:
Octreotide acetate 10mg, 20mg, 30mg; susp for IM inj after dilution; contains mannitol.

Company:
Novartis Pharmaceuticals Corp

Therapeutic Use:

Indications for SANDOSTATIN LAR DEPOT:

Long-term treatment of severe diarrhea and flushing due to metastatic carcinoid tumors; and profuse watery diarrhea due to vasoactive intestinal peptide-secreting tumors in patients whom immediate-release (IR) octreotide acetate has been shown to be effective and tolerated.

Adult:

Give by intragluteal IM inj. Not currently receiving octreotide: initiate therapy with immediate-release octreotide SC inj for at least 2 weeks. Continue immediate-release octreotide therapy for ≥2 weeks, up to 3 or 4 weeks, after initial switch to LAR. Initially 20mg every 4 weeks for 2 months. After 2 months: if symptoms are controlled, may reduce to 10mg every 4 weeks; if symptoms are not controlled, may increase to max 30mg every 4 weeks. Dialysis or cirrhosis: initially 10mg every 4 weeks. Treat exacerbations with immediate-release octreotide SC inj at same dosage prior to switch.

Children:

Not recommended.

Warnings/Precautions:

Diabetes. Hypothyroidism. Cardiovascular disease. Renal or hepatic impairment. Carcinoid tumors: monitor 5-HIAA, plasma serotonin, plasma Substance P. VIPomas: perform baseline and periodic total and/or free T4 measurements with chronic therapy. Monitor thyroid function, gallbladder, glucose, vitamin B12. Pregnancy (Cat.B). Nursing mothers.

Interactions:

Potentiates bromocriptine, CYP450 substrates (eg, quinidine, terfenadine), bradycardia-inducing drugs (eg, β-blockers, calcium channel blockers). Antagonizes cyclosporine. Not compatible with TPN solutions. May need to adjust antidiabetic agents. May affect agents used to control fluid and electrolyte balance.

See Also:

SANDOSTATIN

Pharmacological Class:

Somatostatin analogue.

Adverse Reactions:

Gallbladder abnormalities (eg, gallstones, biliary sludge), GI upset, bradycardia, conduction abnormalities, arrhythmias, hyperglycemia, hypoglycemia, hypothyroidism, injection site pain, headache, dizziness, pancreatitis, altered dietary fat absorption.

How Supplied:

Ampules 50mcg/mL, 100mcg/mL, 500mcg/mL (1mL)—10; LAR kit—1 (5mL vial w. supplies)

Indications for SANDOSTATIN LAR DEPOT:

Long-term maintenance therapy of acromegaly in patients who have had an inadequate response or cannot be treated with surgery and/or radiotherapy and in whom immediate-release (IR) octreotide acetate is effective and tolerated.

Adult:

Give by intragluteal IM inj. Not currently receiving octreotide: initiate therapy with immediate-release octreotide SC inj for at least 2 weeks. Switching from octreotide IR: initially 20mg every 4 weeks for 3months. After 3months, adjust as follows: GH≤2.5ng/mL, IGF-1 normal and clinical symptoms controlled: maintain dosage at 20mg every 4 weeks; GH≤1ng/mL, IGF-1 normal and clinical symptoms controlled: reduce to 10mg every 4 weeks; GH>2.5ng/mL, IGF-1 elevated and/or clinical symptoms uncontrolled: increase to 30mg every 4 weeks; may increase to max 40mg every 4 weeks. Pituitary irradiation recipients: withdraw therapy for 8 weeks once yearly to assess disease activity; resume if GH or IGF-1 levels increase or signs/symptoms recur.

Children:

Not recommended.

Warnings/Precautions:

Diabetes. Hypothyroidism. Cardiovascular disease. Renal or hepatic impairment. Monitor growth hormone, IGF-1 levels, thyroid function, gallbladder, glucose, vitamin B12. Pregnancy (Cat.B). Nursing mothers.

Interactions:

Potentiates bromocriptine, CYP450 substrates (eg, quinidine, terfenadine), bradycardia-inducing drugs (eg, β-blockers, calcium channel blockers). Antagonizes cyclosporine. Not compatible with TPN solutions. May need to adjust antidiabetic agents. May affect agents used to control fluid and electrolyte balance.

See Also:

SANDOSTATIN

Pharmacological Class:

Somatostatin analogue.

Adverse Reactions:

Gallbladder abnormalities (eg, gallstones, biliary sludge), GI upset, bradycardia, conduction abnormalities, arrhythmias, hyperglycemia, hypoglycemia, hypothyroidism, injection site pain, headache, dizziness, pancreatitis, altered dietary fat absorption.

How Supplied:

Ampules 50mcg/mL, 100mcg/mL, 500mcg/mL (1mL)—10; LAR kit—1 (5mL vial w. supplies)

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